310077_Application_20230131

Engineer's Seal
5. FARM
thatthis application for, rU le
been reviewed by me and is accurate an
application are not completed and that it
package will be returned as incomplete,
Date
name listed in question 1.2), attest
V- 77 (Fa ility name listed in question 1.1) has
the best of my knowledge. I understand t at if all required parts of this
supporting information and attachments a e not included, this application
Signature MUM —
6. MANAGER'S CERTIFICATIOIQ: (complete only if different from the Farm (
r (Manager's name
..r... ., r..
been reviewed by me and is accurate and complete to the best of my knowledge. I understand
application are not completed and that if all required supporting information and attachments:
package will be returned as into r lete.
Signature r Date_,
THE COMPLETED APP ATION PACT 'ENG A
, INC DILL SUPPORTING INFOF
SHOULD BE SENT TO E FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF WATER RES
WATER QUALITY PERMITTING SECTI(
ANIMAL FEEDING OPERATIONS PROGR
1636 MAIL SERVICE CENTER
RAtEICZH, NORTH CAROLINA 27699-16:
TELEPHONE NUMBER: [phone]
sted in question 1.7), attest that this
ility name listed in question 1.1) has
it if all required parts of this
not included, this application
TION AND MATERIALS,
ELECTRONIC SUBMISSION IS ENCOURAGED. EMAIL TO: RAMESH.RA�[e-mail]
7. SURFACE WATER CLASSIFICATION:
This form must be completed by the appropriate DWR regional office and included as a
part of the project submittal information.
INSTRUCTIONS TO NC PROFESSIONALS:
The classification of the downslope surface waters (the surface waters that any overflow from the facility would flow toward) in
which this animal waste management system will be operated must be determined by th appropriate DWR regional office.
Therefore, you are required, prior to submittal of the application package, toJbe
mit this form, with items 1 through 6
completed, to the appropriate Division of Water Resources Regional Operations Supeor (see page 6 of 6). At a minimum,
you must include an 8.5" by I I" copy of the portion of a 7.5.minute USGS TopograpMap which shows the location of this
animal waste application system and the downslope surface evaters in which they willlocated. Identify the closest
FORM: AWO-STATE-G-DIGESTER-7/15/2022
5 of 6 . o-